TRANSITIONING TO ELECTRONIC MEDICAL RECORDS: KEY ADVANTAGES OF ADOPTING A BEHAVIORAL HEALTH SPECIFIC EMR OVERVIEW This whitepaper helps behavioral health care practices navigate the process of adopting a digital record keeping system in the form of an EMR system. The paper talks about the key advantages to implementing an EMR within your practice, discusses how to determine if your business is ready to adopt an EMR, and covers the basics of selecting an EMR system. THE ADVANTAGES OF GOING DIGITAL Whether you run a large psychiatric practice or are a single therapist office, adopting an integrated electronic medical record (EMR) system significantly reduce time spent on repetitive administrative tasks (billing, clinical notes, scheduling, etc.) by streamlining and organizing your back-office processes. For example, a small solo therapist practice seeing just 20 patients per week will save up to 4.5 hours of administrative time for the practitioner/manager using an EMR. For larger psychiatric practices with dedicated office staff supporting multiple clinicians, the time savings is significantly higher, allowing for additional patient growth without increasing support staff. While time savings is the most visible benefit of an EMR system, process efficiency brings significant benefits too. Information stored in the electronic format is not prone to human error and can be retrieved easily at the touch of a button. Search and retrieval times are a fraction of what they would be in manual systems, allowing you to maintain more accurate medical information and make medication management a breeze. Additionally, EMR 1
record keeping provides a systematic way to document patient interactions, which protects practices from potential legal liability. When integrated with electronic billing (e-billing) an EMR system can significantly shorten account receivable cycles. Good EMR systems with e-billing capability provide aged account reports that highlight submission/approval bottlenecks which often get in the way of traditional paper-based or contract billing processes. Web-based EMR systems provide unique advantages as well. With a webbased EMR Solution, information is always accessible-anytime, anywhere: Doctors and other medical personnel can access medical records from their smartphone, handheld tablet or laptop. There is no longer a need to rely on paperwork left at the office. Additionally, web-based systems do not require you to purchase special hardware or manage the configuration and updating of software on your practice machines. All that is required is an internet connection and browser to access your secure site. DETERMINING IF YOU ARE READY FOR AN EMR Determining whether your practice is ready to take the step from paper to digital is an easy decision for a practice that is just starting out. However, for established practices that have a manageable workflow the reasons to transition are not always clear. So, how does a practice know when they should make the switch? Meaningful Use Compliance: If you accept either Medicaid or Medicare payments, adopting a certified EMR system may entitle you to incentive payments under the Meaningful Use incentive program. If you adopt in 2012, you can be eligible for up to $44,000 in Medicare or $63,750 in Medicaid payments New or Growing Practice: If your practice is growing, adoption of an EMR system will dramatically improve your ability to increase your patient flow by streamlining the time and costs associated with patient management. Established High Volume Practices: High-volume patient clinics, larger multi-disciplined practice, and a psychopharmacology practice will benefit from the time/cost efficiency of record handling and process controls brought about by use of the EMR by clinicians and office staff. Established Low Volume Practices: If you run an established practice that sees fewer than 20 patients per week, or you are looking to wind down your practice, an integrated EMR can simplify your overall practice and reduce reliance on contract billing support. WHAT DOES YOUR PRACTICE NEED? Recognizing the signs of how an EMR system can beneficial to your practice can be deceptively obvious: 2
Your practice is drowning in paperwork, scheduling and claim submissions. The most common reason that practices seek an EMR system is to reduce paperwork associated with scheduling, clinical note taking, and billing. A behavioral health care EMR will streamline and organize administrative tasks saving you time and improving overall practice efficiency You are spending a lot of time on clinical documentation or worse, not doing it at all. If you find yourself writing the same notes over and over, an EMR system designed for note-taking will make your life significantly easier. Your practice struggles to keep up with billing or spends too much time addressing billing errors. An EMR with electronic billing capability will significantly decrease time spent on billing, reduce errors and shorten payment cycles. Your practice spends significant time managing and prescribing medication, submitting and renewing prescriptions. An EMR with e- Prescribing capability saves time by enabling you to send prescriptions electronically to the patient s pharmacy, rather than having to hand-write prescriptions. Your office process varies from one staff member to the next. If your office-staff and clinicians seemingly follow their own process and procedures for getting things done, adopting an EMR system will get everyone following the same workflow process and eliminate the risk of losing valuable knowledge. CHOOSING AN EMR Searching for an Electronic Medical/Health Record (EMR/EHR) can be a time consuming process. You need to be sure you make the right decision and address the critical questions of: does it meet your needs, comes with positive recommendations, boasts reliability, and fits within budget? The following section talks about key considerations to think about: Web-based vs. client server This decision will have a big impact on where and when you will have access to your EMR. A web-based EMR (web-based software is also known as hosted' software) is hosted online. You log in to a secure website to access your medical records. A client server-based EMR consists of software that you purchase and install on your computer or office server. Here is a breakdown of the important factors that differentiate these two options: Web-based EMR Accessibility: Since the EMR is hosted online, it is accessible from any webenabled computer. If you do not have an internet connection, you will not be able to access your EMR. Some web-based EMRs allow for you to work offline and upload documents when you regain internet access. 3
Performance: The performance and speed of the EMR will be dependent upon your internet connection. A reliable high-speed internet connection is recommended for webbased EMR system. Data Backups: Regular backups are performed by the EMR service provider to eliminate the risk of data loss. While you do not need to back up data locally, a good web-based EMR will still give you the option to do so. Software Updates: Updates and maintenance are performed by the EMR service provider. You will automatically have access to new functionality when updates are released. Client server EMR Accessibility: Since you will be installing software on your computer or server, the EMR will only be accessible from computers on which the software has been installed (or computers that are connected to the server on which the software is installed). Performance: The performance and speed of the EMR will be dependent upon the memory and speed of your computer. Data Backups: It is your responsibility to back up the data. If you backup data in hard copy, you often have to move old records to a secure off-site location to preserve them in case of an office disaster. Software Updates: You are responsible for installing software updates. (If you choose a client-server based EMR, be sure to ask the EMR vendor about the fees associated with their software updates). EASE OF USE VERSUS POWER Think about your main goals for your behavioral health care EMR. Are you simply looking to go paperless and organize your clinical documentation electronically (and qualify for Meaningful Use incentives in the process), or are you looking to customize, arrange, and analyze data in complex ways? The answer to this question will likely depend on your level of computer skill. For behavioral health care providers the primary goal is often organization and process efficiency. A basic behavioral health care EMR should allow you to organize each patient's clinical documentation with a simple interface, provide the ability to sort notes by document type (i.e. intake note, progress note, psychotherapy note), and upload scanned documents to patients' charts. A complex behavioral health care EMR will have more options like adjustable document templates and customized reporting functions. Keep in mind that a feature- rich system can only reach its full potential if the user's technical ability allows him/her to use the functionality in a meaningful way. IMPLEMENTATION, TRAINING & TECHINCAL SUPPORT 4
Before you purchase an EMR, you should have an idea of timeframe, cost, and resources necessary to get you up and running with the system after the initial purchase. If you choose an EMR that requires software installation, you may need to enlist the help of a technically-oriented staff member (or friend/family member) to help with the installation. With a web-based EMR, there is little or no setup to be done on your end, as the EMR provider will configure your account and provide you with your login information. You should also find out if training and technical support is included in the base price of the EMR. If not, be sure to get a clear written description of cost structure and timeframe for which Software Updates: Updates and maintenance are performed by the EMR service provider. You will automatically have access to new functionality when updates are released. Client server EMR Accessibility: Since you will be installing software on your computer or server, the EMR will only be accessible from computers on which the software has been installed (or computers that are connected to the server on which the software is installed). Performance: The performance and speed of the EMR will be dependent upon the memory and speed of your computer. Data Backups: It is your responsibility to back up the data. If you backup data in hard copy, you often have to move old records to a secure off-site location to preserve them in case of an office disaster. Software Updates: You are responsible for installing software updates. (If you choose a client-server based EMR, be sure to ask the EMR vendor about the fees associated with their software updates). WORKFLOW FUNCTIONS A good EMR system can adapt to the user's workflow. Be sure that you have taken your workflow preferences into account. If you are not comfortable with typing, search for an EMR that incorporates features such as voice recognition, transcription options, or structured data such as checkboxes and drop-down menus. If you like tasks reminders to do your clinical notes, look for an EMR that has reminder and alert functions. By adopting a system that is specifically geared for your type of practice, you will fully realize the benefits of your EMR. By selecting an EMR system that builds its platform around the highly specific functions of your practice, you are able to only pay for the product that works for you. In behavioral health care practices, clinical documentation is of the utmost importance and therefore finding a system that has templates and can recognize and capture narrative form information is imperative. 5
CONCLUSION Now that you are armed with guidelines to determining whether an EMR is the correct option for your practice, the next steps are to research and experience. Your search for an EMR needs to be based on your needs and desired features. Create a list that answers these questions and ask to see a demonstration of a product before you purchase. Research the benefits this new system would have for your practice and be sure to include your office staff in the decision making process. This search may seem daunting, but the rewards of finding the right EMR for your practice is worth your time and effort. Ultimately, an EMR can enhance the quality of your practice and your life. 6